title: Intrathoracic esophageal replacement by in situ tissue-engineered esophagus.
abstract: OBJECTIVE
  This study aimed to evaluate in situ tissue-engineered esophagus in a canine model after experimental resection and replacement of a full circumferential defect of the intrathoracic esophagus.
  
  
  METHODS
  Two types of scaffolding were fabricated. In the KF(+) group (n = 6), oral keratinocytes and fibroblasts cultured on human amniotic membrane were sheeted on polyglycolic acid felt with smooth muscle tissue and were then rolled around tubes. In the KF(-) group (n = 6), the same procedure was followed, but the keratinocytes and fibroblasts were omitted. Both scaffolds were wrapped in omentum and implanted in the abdomen. In the KF(+) group, at 3 weeks after implantation, the scaffold developed into a tube with a well-differentiated lumen of stratified squamous cells surrounded by a thick smooth muscle-like tissue (in situ tissue-engineered esophagus). A part of the esophagus was resected and replaced by the graft in the same dogs.
  
  
  RESULTS
  In the KF(-) group, strictures developed after esophageal replacement, with almost complete obstruction within 2 to 3 weeks. In contrast, in the KF(+) group, the in situ tissue-engineered esophagus showed good distensibility and the dogs remained without feeding problems through 420 days. Esophageal peristalsis transferred food to the stomach, despite the absence of peristaltic activity in the in situ tissue-engineered esophagus itself. The thickness of the squamous epithelial layer and the smooth muscle layer of the in situ tissue-engineered esophagus were similar to that of the adjacent native esophagus.
  
  
  CONCLUSIONS
  The in situ tissue-engineered esophagus can successfully replace the intrathoracic esophagus, and this procedure may offer a promising surgical approach to esophageal diseases.
authors.affiliation: Department of Surgery and Regenerative Medicine, Division of Surgery and Physiology of Digestive System, Graduate School of Medical Sciences, Kyoto Prefectural University of Medicine, Kyoto, Japan. yuen-n@koto.kpu-m.ac.jp
authors.forename: Yuen
authors.initials: Y
authors.lastname: Nakase
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Nakamura
authors.forename: Shuichi
authors.initials: S
authors.lastname: Kin
authors.forename: Susumu
authors.initials: S
authors.lastname: Nakashima
authors.forename: Tetsuji
authors.initials: T
authors.lastname: Yoshikawa
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Kuriu
authors.forename: Chohei
authors.initials: C
authors.lastname: Sakakura
authors.forename: Hisakazu
authors.initials: H
authors.lastname: Yamagishi
authors.forename: Junji
authors.initials: J
authors.lastname: Hamuro
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Ikada
authors.forename: Eigo
authors.initials: E
authors.lastname: Otsuji
authors.forename: Akeo
authors.initials: A
authors.lastname: Hagiwara
mesh_terms: D000714:Anastomosis, Surgical; D000818:Animals; D021522:Bioartificial Organs; D004195:Disease Models, Animal; D004285:Dogs; D016629:Esophagectomy / Q000379:methods; D004947:Esophagus / Q000473:pathology* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D006085:Graft Survival; D007150:Immunohistochemistry; D011897:Random Allocation; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013908:Thoracotomy / Q000379:methods; D023822:Tissue Engineering / Q000379:methods*